Method for orthodontic treatment

ABSTRACT

After securement of brackets to teeth of a patent to be treated, an impression is taken of the mouth. The impression is removed, replicas of brackets are inserted in the impression and a simulation or model is made, as by positioning castings of the teeth made in the impression, in ideal locations in the model. Arch wires are then preformed to fit brackets on the ideal model and after preforming, the arch wire is transferred to the brackets previously mounted on teeth of the patient.

States Patent 1 [11'] 3,8425% Oct. 22, 1974 METHOD FOR ORTHODONTIC3,578,744 5/1971 Wildman 32/14 A TREATMENT [75] Inventor: Alexander J.Wildman, Eugene, Primary Examiner-Louis G. Mancene Oreg. Attorney,Agent, or Firm-Jerald E. Rosenblum; [73] Assignee: Silverado IndustriesInc., Napa, Thomas Schneck Calif.

[22] Filed: Aug. 29, 1973 [57] ABSTRACT {21] Appl- N05 392,483 Aftersecurement of brackets to teeth of a patent to be Related A fi ti Datatreated, an impression is taken of the mouth. The im- [60]continuatiommpw of Sm NO 5 4 Ma 27 pression is removed, replicas ofbrackets are inserted 1970' aband0ned which a i a in the impression anda simulation or model is made, 85735], Sept 12, 1969 p 3,578744 as bypositioning castings of the teeth made in the impression, in ideallocations in the model. Arch wires 52 us. (:1. 32/14 A, 32/71 arePreformed t0 fit brackets on the ideal model 51 m1. Cl. A61c 7/00 andafter Preforming, the arch wire is transferred to 58 Field of Search32/1, 14 A, 71 the brackets Previously mounted on teeth of the P tient.

[56] References Cited UNITED STATES PATENTS 4 Clams N0 Dawmgs l,l(l2.3907/1914 Dalton 32/7] METHOD FOR ORTHODONTIC TREATMENT RELATEDAPPLICATIONS This application is a continuation-in-part of ser. no.51,41 1 filed May 27, 1970 for Method and Apparatus for OrthodonticTreatment (parent) now abandoned. The parent application is a divisionof the prior application, Ser. No. 857,351, filed Sept. 12, 1969,entitled Method and Apparatus for Orthodontic Treatment which maturedinto U.S. Pat. No. 3,578,744. A reissue application for said patent,ser. no. 229,217 filed Feb. 24, 1972 is now pending.

BACKGROUND OF THE INVENTION In accordance with what is known as thedirect method of orthodontic work, bands are positioned around theindividual teeth of a patient with brackets to permit connection of thebands to the arch wire and various spring wires as are ordinarilyutilized. This technique requires considerable skill and judgment on thepart of an orthodontist in manipulating and forming the various forceapplying wires so as to attain the desired movement of teeth.

In accordance with the so-called indirect method utilized heretofore,bands and arch wires are formed in an ideal model and then transferredto the patient. However, it is virtually impossible to secure the bandson the patients teeth in the same location as on the model.

SUMMARY OF THE INVENTION In accordance with the method of the inventionand utilizing the apparatus of the invention, an orthodontist is enabledto perform the difficult and intricate task of forming an arch wire soas to obtain the desired tooth movement on an ideal model of the teethof the patient while the arch wire is out of the mouth. Thereafter, thearch wire can be transferred to the patients mouth and easily andquickly secured to brackets on the individual teeth. The teeth are thenguided to the positions on the ideal model.

More particularly, in accordance with the method of the invention, archwire brackets are secured by bands to the teeth of a patient after whichan impression is made of the patients mouth. After removal of theimpression, replicas of the brackets are inserted in a correspondingposition in the impression and a casting made of the teeth in the courseof which the brackets will become rigidly attached to the toothcastings. Thereafter, the individual tooth castings are separated andreset in an ideal model of the patients mouth whereupon an arch wire canbe formed so as to conform to the bracket locations of the teeth in theideal model. After formation of such wire, it is transferred to thepatients mouth, whereupon the memory of the wire will apply correctiveforce to the teeth causing them to move towards their ideal location.

DESCRIPTION OF THE PREFERRED EMBODIMENT In accordance with the method ofthe invention, the orthodontic brackets are mounted on bands and aresecured to the teeth of a patient. An impression of the patients mouthis taken so as to obtain an impression of the position of the teeth withthe brackets attached thereto. The impression is removed from the mouthand an ideal model of the patients mouth is made. For example, replicasof the brackets are inserted in the corresponding apertures formed inthe impression. Thereafter, a casting is made in the impression so as toobtain a model of the patients teeth with the bracket replicas attachedto the cast teeth. Next, the individual tooth castings are separated bycutting or other suitable means and reset in their ideal locations in amodel. Next, an arch wire is formed so as to fit the brackets of theideal model and upon its completion this arch wire is removed andattached to the brackets on the teeth in the patients mouth, the memoryof the wire will apply the desired pressure to the teeth in the mouth tocause them to rotate or tip or otherwise move as desired towards theideal location. It may be preferred to start the treatment with a wireapplying only a small amount of force and to increase the force appliedas the treatment continues by changing the wire. In any case, the ortho'dontist can go back to his ideal model for forming the arch wire whichis to be positioned in the patients mouth.

While the technique described herein will work with almost any bracket,this technique has been previously described with reference to a bracketof my design in U.S. Pat. No. 3,578,744 to A. J. Wildman, the disclosureof which is hereby incorporated by reference.

Because of the simplicity of the model making method described herein,the arch wires may be mounted on the lingual side of the teeth as wellas the labial side, as presently done. This is possible because bracketsmay be secured directly to teeth without bands. Thus, for cosmeticreasons, or otherwise, it may be desired to mount a lingual arch wire.

In order to mount brackets to the lingual side of the teeth, thebrackets are preferably mounted on the teeth without bands. Two methodsfor doing this are as follows:

In the first method, brackets are adhesively mounted on the patientsteeth and the brackets are covered with elastomeric caps. An impressionis then taken of teeth with the brackets covered. The mounted covers arethen removed from the teeth and are discarded.

Next, a replica of each tooth is made or obtained, as by casting, and abracket is mounted on each replica in the space provided by the caps.The replicas are then placed in ideal positions simulating an idealposition for all the teeth relative to each other and an ideal arch wireis formed. The ideal arch wire is then removed from the ideal model andmounted in the brackets on the patients teeth.

In the second method, an impression of a patients teeth is made, whichis duplicated in investment, a heat resistant material used in dentalcastings. Next, a thin layer of wax is placed on the back sides of theduplicate teeth so that a wax shell is formed thereon. Then wax replicasof the desired brackets are placed on the wax shell at locationscorresponding to desired locations on the actual teeth. Next thin waxtubes are radially connected from each wax bracket to an upward sprue,and above that is connected a reservoir. The whole assembly is placed ina crucible and the plenum of the crucible filled with investment so thatno empty space exists, except in the tubes. Next the wax is dissolvedand molten metal, i.e., bracket and base material, is poured in. The hotinvestment is quenched in water, causing it to shatter, leaving bracketsmounted on bases which fit onto individual teeth on the lingual sidethereof. The

brackets and bases are cleaned, as by sandblasting, so that no mark leftby the tubes is apparent. The individual bases and brackets are thenseparated. The individual bases have a contour matching the shape ofeach tooth, with each base extending from one side of the back of atooth to the other side so that each base indexes the position of thecorresponding bracket on one tooth.

The individual teeth of the original impression are now separated withthe new base and bracket castings temporarily mounted on each one. Theteeth are then placed in ideal positions relative to each other, formingan ideal model, and an ideal arch wire is formed using the bracketsthereon. Next each bracket integrally connected to a custom fittingbase, is mounted on a corresponding tooth of a patient and the idealarch wire is mounted thereon.

In summary, the method disclosed herein includes the steps of affixingbrackets to the teeth of a patient. The brackets are of a conventionaltype for holding arch wires. Next an impression is made of the teethwith brackets thereon. The impression is then used in setting up asimulation or model of an ideal position for the teeth. One way to setup such an ideal model is to insert replicas of the brackets into theimpression and cast a replica of each tooth and bracket, then separatethe castings and mount the teeth to form a model. Another way toaccomplish the same thing is to position brackets on a tooth simulatorcorresponding to the position brackets have been mounted on the patientsteeth. In either instance, the position of the brackets on the patientsteeth is used in the model process thereby overcoming the prior artproblem of attempting to fix the brackets to the teeth after the archwire is formed.

The next step involves removing the arch wire or wires from the modeland attaching the arch wires to the brackets on the teeth in a patientsmouth. The arch wire or wires then urge the patients teeth to theirideal position.

One advantage of the present method is that it will greatly simplify thepractice of orthodontic dentistry in the following manner. Apractitioner will mount brackets directly on a patients teeth and makean impression. He can then send the impression to a laboratory whereprecision arch wires are formed. The laboratory will use the impressionto make an ideal model by simulating ideal positions for the patientsteeth and the position of brackets thereon. The bracket position isknown exactly relative to the tooth because the impression gives theexact position. Thus, the arch wire or wires formed in the laboratorywill correspond to the ideal positions determined in the laboratory.

We claim: 1. In a method of orthodontry for positioning teeth in desiredtooth positions the steps comprising,

affixing, to the teeth in a patients mouth, brackets which are to befixed to arch wires, making an impression of the teeth with the bracketsthereon, simulating the position of each tooth in an ideal model and theposition of the brackets thereon, forming arch wires in said ideal modelso as to conform to the desired tooth positions on said model,

removing said arch wires from said model and attaching said wires to thebrackets on the teeth in a patients mouth.

2. The method of claim 1 wherein said brackets and arch wires areapplied to the lingual side of the teeth.

3. The method of claim 1 wherein said brackets and arch wires areapplied to the labial side of the teeth.

4. The method of orthodontry which comprises,

affixing, to the teeth in a patients mouth, bands and brackets which areto be fixed to arch wires,

taking an impression of the teeth with the bands and brackets thereon,

removing the impression from the mouth and inserting replicas of thebrackets into the impressions,

casting a replica of each tooth in said impression thereby to bond saidbracket replicas to the cast teeth,

separating the individual tooth castings,

mounting the separating tooth castings to form a model having the teethin the desired ideal location,

forming arch wires to the brackets on the teeth in said ideal model soas to conform to the desired tooth positions on said model,

removing said arch wires from said model and attaching said wires to thebrackets on the teeth in the patients mouth.

1. In a method of orthodontry for positioning teeth in desired toothpositions the steps comprising, affixing, to the teeth in a patient''smouth, brackets which are to be fixed to arch wires, making animpression of the teeth with the brackets thereon, simulating theposition of each tooth in an ideal model and the position of thebrackets thereon, forming arch wires in said ideal model so as toconform to the desired tooth positions on said model, removing said archwires from said model and attaching said wires to the brackets on theteeth in a patient''s mouth.
 2. The method of claim 1 wherein saidbrackets and arch wires are applied to the lingual side of the teeth. 3.The method of claim 1 wherein said brackets and arch wires are appliedto the labial side of the teeth.
 4. The method of orthodontry whichcomprises, affixing, to the teeth in a patient''s mouth, bands andbrackets which are to be fixed to arch wires, taking an impression ofthe teeth with the bands and brackets thereon, removing the impressionfrom the mouth and inserting replicas of the brackets into theimpressions, casting a replica of each tooth in said impression therebyto bond said bracket replicas to the cast teeth, separating theindividual tooth castings, mounting the separating tooth castings toform a model having the teeth in the desired ideal location, formingarch wires to the brackets on the teeth in said ideal model so as toconform to the desired tooth positions on said model, removing said archwires from said model and attaching said wires to the Brackets on theteeth in the patient''s mouth.